A&P Chapter 23

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Author:
Shells33
ID:
278047
Filename:
A&P Chapter 23
Updated:
2014-07-02 16:46:28
Tags:
CRNA
Folders:
A&P
Description:
Heart Valves, Heart Sounds, Valvular and Congenital Heart Defects
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  1. S1 indicates....
    closure of the AV valves/beginning of systole
  2. S2 indicates.....
    closure of the semilunar valves/end of systole
  3. S3 and S4 are both caused by....
    blood rushing in the ventricles from the atria
  4. If you can hear an S3 it might indicate...
    CHF
  5. When can you hear an S4?
    late it diastole in a patient with hypertension and a thick LV
  6. Rheumatic Fever is caused by what bacteria? Which valves are most commonly damaged?
    • Group A hemolytic streptococci
    • 1) Mitral Valve
    • 2) Aortic Valve
  7. What are the 3 etiologies of heart murmurs?
    • 1) Infectious lesions (IV drug abuse, dental decay)
    • 2) Congenital defects (Stenosis or lack of one or more lesions)
    • 3) Degenerative defects (Calcific aortic stenosis)
  8. Aortic stenosis is a _____ murmur
    systolic
  9. Aortic stenosis is a _______ overload? Which type of LV hypertrophy will occur?
    pressure - concentric hypertrophy
  10. What is the normal aortic valve area?
    2.5-3.5 cm2
  11. How do you define severe aortic stenosis?
    pressure gradient > 50 mmHg or an aortic valve opening < 1 cm2
  12. What 3 symptoms are commonly associated with aortic stenosis?
    DOE, syncope, angina pectoris
  13. What % of aortic stenosis patients are male?
    80%
  14. Aortic Regurgitation is heard during _____ in the ______.
    diastole in the LV
  15. Aortic Regurgitation is a ______ overload murmur and produces what type of hypertrophy?
    volume overload - eccentric hypertrophy
  16. Mitral Regurgitation is heard during _____ in the ______.
    systole in the left atrium (best heard at the apex)
  17. Mitral regurgitation is a ______ overload lesion.
    volume
  18. When and where do you hear mitral stenosis?
    last 1/3 of diastole over the apex
  19. How big is the opening of the mitral valve? when do patient's become symptomatic?
    4-6 cm2

    < 50% reduction in opening
  20. Both MR and MS cause and increased ______ pressure. This increases the risk of ___ and _____.
    LA pressure. Increased risk of a fib and pulmonary edema.
  21. Mitral Stenosis is a ______ overload lesion.
    pressure
  22. Tetralogy of Fallot produces a ____ shunt.
    right to left
  23. Atrial septal defect produces a ____ shunt
    left to right
  24. ventricular septal defect produces a _____ shunt
    left to right
  25. patent ductus arteriosus produces a ____ shunt
    left to right
  26. When do you hear the murmur produced by a PDA?
    through systole and diastole - more intense during systole
  27. What pathology can be caused by a PDA?
    the increased pulmonary flow can cause RV hypertrophy
  28. What is the danger with a septal defect?
    air embolism/clot will go to systemic circulation --> stroke/blindness/ischemic organ etc
  29. What % of the population has an ASD but doesn't know - how do they not know?
    33% - LA pressure creates a pseudo closure so they are asymptomatic
  30. Where and when will you hear the murmur from an ASD?
    systolic - over pulmonic valve
  31. When and where do you hear a VSD murmur?
    holosystolic - left sternal border
  32. What eventually happens with a VSD left untreated?
    increased pulmonary flow --> increased PA until PAP > ABP --> reversal of shunt to a right to left shunt = cyanotic defect
  33. What are the findings you see on an EKG and CXR with ASD? VSD?
    ASD: Right axis deviation, RBBB on EKG. CXR = prominent pulmonary arteries

    VSD: normal unless plum HTN develops, then right axis deviation
  34. What are the 4 defects of TOF?
    • 1) Aorta originates from RV
    • 2) PA stenosis
    • 3) VSD
    • 4) RV Hypertrophy

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